Hyperglycaemia as a predictor of morbidity and mortality in patients receiving an allogeneic haematopoietic stem cell transplantation.

Allogeneic haematopoietic stem cell transplantation (allo-HSCT) is an effective treatment for patients with haematological malignancies; however, post-transplant complications, including infections and acute graft-versus-host disease (aGvHD), remain significant issues. Identifying modifiable risk factors is therefore critical to improve patient outcomes. This retrospective study evaluated the impact of hyperglycaemia on post-transplant outcomes in adult patients undergoing allo-HSCT at the University Medical Centre Groningen between 2018 and 2024. Hyperglycaemia was defined as a glucose level exceeding 10 mmol/L in capillary or venous samples. In total, 575 patients were included. The median age was 61 years (interquartile range [IQR]: 52-68); 64% were male, and the median body mass index (BMI) was 25.3 kg/m2 (IQR: 23.1-28.0). During hospitalization, 26.6% of patients experienced at least one episode of hyperglycaemia. After adjusting for confounding variables, hyperglycaemia was associated with significantly reduced 100-day overall survival (hazard ratio [HR] 2.36, 95% confidence interval [CI] 1.29-4.33). It was also linked to an increased risk of severe (grade ≥3) aGvHD and infections. Importantly, hyperglycaemia occurring within 30 days prior to transplantation already predicted poorer survival. In conclusion, hyperglycaemia at any moment during allo-HSCT is predictive for treatment-related adverse events. Since glucose levels are highly modifiable, closer attention and timely intervention might improve outcomes.